Does serum osmolarity change as a result of the reflex neuroprotective mechanism of cerebral osmo-regulation after minor head trauma?

J Korean Neurosurg Soc. 2009 Mar;45(3):151-6. doi: 10.3340/jkns.2009.45.3.151. Epub 2009 Mar 31.

Abstract

Objective: It is well known that changes in cerebral hemodynamics occur after traumatic brain injury (TBI). Osmo-regulation in the brain is important for maintaining a constant milieu in the central nervous system. Nevertheless, to our knowledge, early osmolarity changes after minor head injury have not been studied until now.

Methods: In this study, serum osmolarity was measured in 99 patients with minor head trauma. As a control group, blood samples were drawn from 99 patients who had a minor trauma in an extremity. Serum osmolarity was estimated using a fully automatic biochemical autoanalyzer within the first 3 hours after the trauma.

Results: The mean serum osmolarity levels were 286.08+/-10.17 mOsm/L in the study group and 290.94+/-5.65 mOsm/L in the control group (p<0.001). However, after age adjustment between the study and control groups, this statistical significance was found to be valid only for patients over 30 years of age.

Conclusion: It was noted that serum osmolarity levels decrease in the first 3 hours following minor head trauma in patients over 30 years of age. Further studies into this area could provide guidance for the management/treatment of elderly patients.

Keywords: Biomarkers; Brain injury; Head trauma; Neurophysiology; Osmolarity.